Turns out Gods can make mistakes after all. What you're seeing here is me having just paid 20 Piety (had 44) for Taurog's Blade. He decided to spawn it on the far side of the wall, I'm guessing. Will look in a minute. This is probably annoying to fix directly. Should the game check for an open inventory slot and spawn there first if possible? Hard call. I could see someone with 2-3 inventory slots open trying to do a hoarder run and seeing if anything better might show up before using Taurog's gear, but wanting to spend the piety to keep from overflowing. Is that too niche to worry about?
(I should point out the tile directly under me is empty, I should have stood on altar when taking screenie. The others are all occupied by something or other, but there WAS a free spot.)
EDIT: Yes, it spawned two spaces directly south of the altar, if that helps any.
EDIT 2: Now I'm really conflicted, since that also ended up being my first successful VHoS run. Well, at least the smelly git did something to earn his pictorial immortality. Helped that only 3 curse golems and 2 illusions over level 2 spawned. I probably could have beaten that roll with any class. Got Specialist and Warmonger out of the deal though.